Frontal Lobe Dysfunction in Chronic Mesial Temporal Lobe Epilepsies

Background: Chronic mesial temporal lobe epilepsy patients are known to be associated with dysfunction of visual and verbal memory. Recent studies have shown that executive dysfunction which is present in these patients demonstrates existence of abnormality beyond the site of involvement. Aim: To see whether there is evidence of executive dysfunction in patients with temporal lobe epilepsy and whether it has any correlation with variables like age of onset, duration of illness, number of antiepileptic drugs, side of lesion and seizure frequency. Materials and Methods: 126 consecutive patients who fulfilled the criteria for unilateral chronic mesial temporal lobe epilepsy after detailed evaluation are taken into study. Detailed neuropsychological assessments like Intelligence Quotient, verbal and visual memory in addition to extensive tests of frontal dysfunction are done. Results: All tests of executive function have shown statistically significant dysfunction. Age of onset, number of AEDs, duration of illness, seizure burden are seem to have an effect on the executive function. Quality of life is negatively correlated with tests of planning and working memory. Conclusion: Evidence for frontal lobe dysfunction noted in mesial temporal lobe epilepsies. Mesial temporal lobe epilepsy has effects beyond temporal lobe suggesting the effect of epilepsy on networks. Age of onset, number of AED, duration of illness, side of lesion, seizure frequency seem to have an effect on the executive function. Tests of planning, working memory are correlated with poor quality of life.